The use of single-pill combinations is preferred for severe hypertensive patients to support their effectiveness in improving adherence to therapy and achievement of effective BP control. Aiim of the study is to determine effects of fixed dose indapamide/ amlodipine in patients with high risk factors for coronary artery diseases and severe hypertension.Design and method:
We studied 65 patients with AH(57 ± 16 y, 32% female) and type 2 diabetes, divided on two groups, regarding level of BP from AMBP, analyzed at baseline before therapy and 4 months FU. The group with mild AH received indapamide /amlodipine 1.5/5 mg daily and group with severe AH – indapamide /amlodipine 2.5/10 mg. We divided patients into 3 groups regarding their LV diastolic function (normal – 22 patients, impaired LV relaxation – 33 and impaired relaxation with reduced compliance and elevated LV end-diastolic pressure –10).Results:
At 4 mFU BP decreased by 23.3 ± 13.2/11.6 ± 6.4 to 131.6 ± 5.6/76.0 ± 4.6 mmHg (p < 0.0001). Changes in BP were 19.8 ± 8.3/9.7 ± 7.2 mmHg for grade 1, 20.3 ± 10.5/15.6 ± 9.6 mmHg for grade 2, and 35.3 ± 16.2/19.8 ± 12.2 mmHg for grade 3 AH (p < 0.0001). ABPM 24-h mean BP decreased from 148.6 ± 12.7/78.1 ± 13.6 to 123.7 ± 6.4/77.8 ± 6.5 mmHg (p < 0.0001). Diastolic BP at 16 weeks was significantly lower from baseline (p = 0.001). Lipid profile and glucose status shown slight decrease but was without significant changes from baseline after 4mFU of both fixed dose combination of treatment (p = 0.72). At 4mFU were found improvement of systolic BP more significant in severe AH group, treated with higher dose indapamide/amlodipine (p = 0.01). Data showed improvement after 4mFU treatment in both groups, with a positive correlation between BP parameters and E/Em ratio. Ankle edema was infrequent (0.1%).Conclusions:
Single pill combination indapamide/amlodipine was effectively and safely administered to high-risk hypertensive patients to reach target BP values and may be efficacious as first-line treatment for patients with mild to moderate essential hypertension. After 4months treatment is not injured glycemic and metabolic status.